Smart Prior Authorization Engine
Our solution uses a rules engine specially designed to handle specialty drugs for more comprehensive coverage criteria than traditional prior authorization programs.
Our solution uses a rules engine specially designed to handle specialty drugs for more comprehensive coverage criteria than traditional prior authorization programs.
By leveraging an industry-leading analytics platform, our solution can identify, intervene, and resolve previously undetected specialty savings opportunities.
Using detailed claims data analysis to identify members who are ideal for voluntary site-of-care transition, our solution reaches out to members and prescribers to encourage them to use the most cost-effective, clinically appropriate setting.